Adenocarcinoma do pâncreas localmente avançado e metastizado com resposta completa a quimioterapia

 

P. Freire¹, A, J. Coelho², A. Rodrigues², M. R. Silva³, P. Lapa⁴, B. Graça, A. Porto²

 

Resumo

Os autores apresentam o caso clínico de doente do sexo feminino, 54 anos, raça branca, que recorreu ao médico assistente por dor abdominal associada a manifestações constitucionais. A ecografia revelou massa pancreática e formações nodulares hepáticas compatíveis com lesões secundárias, resultado posteriormente corroborado por tomografia computorizada, que acrescentou critérios de irressecabilidade, nomeadamente invasão dos vasos mesentéricos e do duodeno. A biopsia ecoguiada obteve material cujo estudo anatomopatológico revelou tratar-se de adenocarcinoma do pâncreas. Iniciou quimioterapia, verificando-se melhoria clínica progressiva. A reavaliação imagiológica, após 7 ciclos de tratamento, não detectou a lesão primitiva nem as lesões secundárias, sugerindo resposta completa. Foi mantido esquema regular de quimioterapia, persistindo a remissão 8 meses após a documentação da resposta completa.

 

Adenocarcinoma of the pancreas locally advanced an metastized with complete response to chemotherapy

Summary

The authors present a case study of a 54-year-old white female patient, who went to her regular physician complaining of abdominal pain and constitutional symptoms. An ultrasound revealed a pancreatic mass and hepatic nodular formations compatible with secondary lesions. This finds was subsequently confirmed by computed tomography, which revealed that the pancreatic tumor wasn't resectable due to invasion of the mesenteric vessels and the duodenum. Ultrasound guided biopsy obtained a sample which pathology revealed to be an adenocarcinoma of the pancreas. The patient was submitted to chemotherapy, showing progressive clinical improvement. Imaging reevaluation, after 7 cycles, detected neither the primary lesion nor the secondary lesions, suggesting a complete response. A regular chemotherapy plans was maintained, and the patient remains in remission after an 8 months follow up period.

 

 

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Bibliografia

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Correspondência:

Paulo André Vinagreiro Freire

Serviço de Gastrenterologia dos Hospitais da Universidade de Coimbra.

Praceta Prof. Mota Pinto

3000-075 Coimbra.

Tel.: 239400483

Fax: 239701517.

e-mail: pavfc@clix.pt

 

⁽¹⁾ Serviço de Gastrenterologia, Hospitais da Universidade de Coimbra, Coimbra, Portugal.

⁽²⁾ Serviço de Medicina III, Hospitais da Universidade de Coimbra, Coimbra, Portugal.

⁽³⁾ Serviço de Anatomia Patológica, Hospitais da Universidade de Coimbra, Coimbra, Portugal.

⁽⁴⁾ Serviço de Medicina Nuclear, Hospitais da Universidade de Coimbra, Coimbra, Portugal.

 

Recebido para publicação: 21/03/2006

Aceite para publicação: 16/08/2006